Carolina BEBES Fundraiser Order Form

Breast Health and Breastfeeding Totes & Stickers
Benefitting Living Beyond Breast Cancer and Carolina BEBES

Please use the form below to indicate which items you wish to order and your availability to pick up the items in the School of Public Health (Rosenau building or Hooker atrium). Someone will then follow up to arrange a meeting time. Please have your payment ready at that time (CASH ONLY - university regulations).

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* 1. First Name:

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* 2. Last Name:

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* 3. Phone Number:

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* 4. Email Address:

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Preview

Preview

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* 5. Please select an option:

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* 6. Please select your FIRST sticker (if applicable):

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* 7. Please select your SECOND sticker (if applicable):

Once you have finished filling out and submitting the form, someone will follow up to arrange a meeting time for payment and pick up of your items.

Please be able to meet in either the Rosenau building or the Hooker atrium and have payment ready.
Payments are CASH ONLY (university regulations).

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* 8. When are you generally available to pick up your items?
(Note that actual time will depend on availability of fundraiser organizers - Thanks!)

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